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See a sample rate comparisonHealthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 23 - Emergency Room 20 - Urgent Care Facility |
| Common Modifiers | None 54 - Surgical Care Only F4 - Left hand, fifth digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 26770 |
| Medicaid Fee Schedule | View Medicaid rates for 26770 |
National average reimbursement for CPT 26770 by major payers:

$386.31

$367.32

$409.97

$477.22
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The Surgery Center Of Southwest
Ridgecrest Specialty Surgery Center A Professional Corporation
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 26770 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 26770 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 26770 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 26755-CPT | Moderate | Closed Treatment Of Distal Pha, Closed Treatment Of Distal Phalangeal Fracture Finger Orthumb With Manipulation Each Closed Treatment Of Distal Phalangeal Fracture Finger Or |
| 26756-CPT | Moderate | Percutaneous Skeletal Fixation, Percutaneous Skeletal Fixation Of Distal Phalangealfracture Finger Or Thumb Each Percutaneous Skeletal Fixation Of Distal Phalangeal |
| 26765-CPT | Moderate | Treat Finger Fracture Each, Open Treatment Of Distal Phalangeal Fracture Finger Or Thumb Includes Internal Fixation When Performed Each |
| 26770-CPT | Moderate | Closed Treatment Of Interphala, Closed Treatment Of Interphalangeal Joint Dislocationsingle With Manipulation Without Anesthesia Closed Treatment Of Interphalangeal Joint Disloca Tion |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 26770. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 26770 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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